Influence of preservation solution on early graft failure in clinical lungtransplantation

The aim of this study was to assess the influence of preservation solution type and extra- or intracellular composition on the occurrence of early gra ft dysfunction after clinical lung transplantation. For 170 patients who un derwent a single (n = 124) or bilateral (n = 46) lung transplantation in tw o centers in Paris between 1988 and 1999, the preservation technique applie d to the donor lung was single-flush perfusion of the pulmonary artery with one of several solutions of intracellular (Euro-Collins, n = 61; Universit y of Wisconsin, n = 24) or extracellular composition (Cambridge, n = 64, Ce lsior, n = 21). The early postoperative outcome of these patients was revie wed. Reimplantation edema occurred in 48% of all patients, and the overall 1-mo survival rate was 84%. No significant difference in the incidence of e dema, duration of mechanical ventilation, and 1-mo survival rate was observ ed between the four groups or between intra- and extracellular groups, Afte r adjustment for graft ischemic time by means of multivariate analysis, the use of extracellular preservation fluid was associated with a lower incide nce of reimplantation edema without effect on 1-mo mortality. Graft ischemi c time was associated with both edema occurrence and 1-mo survival rate (p = 0.02 and p = 0.01, respectively). We conclude that extracellular-type sol utions are associated with better lung preservation than intracellular-type solutions in clinical transplantation.